Physical and Emotional Costs of Anxiety Disorders
by Nader Oskooilar, M.D., Ph.D.

Stress could be defined as anything (real, symbolic or imagined) that threatens an individual’s well-being and survival. Stress can be physical or emotional. When under stress, our body activates a large number of biological mechanisms that seek to diminish the impact of the stress and restore balance. Intense or perpetual stress, however, may tax a person’s physiological and psychological resources, harm the brain and its function, as well as damage the body.

The body responds to stress mainly through two systems: first by activating the involuntary (autonomic) section of the nervous system; and second, by secreting hormones. These two systems are closely connected and complement each other. The first system works directly and instantly. The latter reacts slowly but has a wider effect on the body.

The most important hormones of the stress system are adrenaline and cortisol. Adrenal glands (located one on top of each kidney) secrete the hormone adrenaline into the bloodstream. Adrenaline, like the involuntary nervous system, also prepares the body for a fight or flight response. For example, it increases the heart and breathing rates, elevates blood pressure and raises metabolic rate.

Adrenal glands also produce cortisol. This hormone increases blood pressure, mobilizes fat and glucose, subdues allergic reactions, reduces inflammation and can decrease the number of some white blood cells that are involved in dealing with invading particles or bacteria. Consequently, increased cortisol levels over a prolonged period of time lowers the efficiency of the immune system and makes a person potentially more susceptible to infections and even to cancer. Constant secretion of cortisol under chronic stress can also diminish the number of cells in certain parts of the brain and result in memory problems and scarring of the brain. Recent evidence shows it can also lead to osteoporosis.

In terms of evolution, stress might have been protective. It would have helped one to either fight with the source of the stress or flee from it, so that life is preserved. But in modern times, the activation of biological reactions to stress is not channeled into the right conclusion (fight or flight). Instead of being released in a burst of physical exertion, it is internalized. A surge of adrenaline, for example, especially on a chronic basis, causes blood to clot more easily, increasing the risk of a heart attack. Likewise, persistent activation of the autonomic nervous system can put the body in chronic overdrive and bring about premature wear and tear to the organs of the body.

Anxiety disorders are among the most prevalent psychiatric conditions in the United States and they are a major source of stress for patients who suffer from them. These disorders (e.g., Generalized Anxiety Disorder and Social Anxiety) are usually chronic stressors with unknown or multiple possible causes.

Treatment is usually very effective for anxiety disorders. Having chronic anxiety can be detrimental to one’s physical and mental health. Anxious individuals may have more health problems, suffer emotionally for years and decades, be nonfunctional or dysfunctional and not reach their full potential in life. People around them also endure the consequences and there is a great risk for developing other psychiatric disorders such as depression, alcohol and substance abuse and other anxiety disorders. The risks of not treating anxiety disorders far outweigh the potential risks of available safe and effective remedies to treat anxiety disorders.

Present medications are obviously not perfect. They do not work well for everyone or are not well tolerated by some people. That is why pharmaceutical companies are attempting to develop other alternatives that might be more effective and with less side effects.